A retrospective review of cutaneous metastases at the National Skin Centre Singapore

Background/ObjectivesCutaneous metastases occur in up to 10% of all visceral malignancies. This study aims to determine the clinico-epidemiological characteristics of patients diagnosed with cutaneous metastases at a leading Asian tertiary dermatological centre. MethodsA retrospective chart review was carried out on all patients diagnosed with cutaneous metastases from 2001 to 2010, identified through the National Skin Centre's clinical and histological databases. ResultsIn all, 35 patients were diagnosed with cutaneous metastases at a mean age of 65 years, with a female: male ratio of 3:2 and with most (97%) being Chinese. Cutaneous metastases were the first presentation of cancer in 34% of patients (n=12). The two commonest primaries were breast (49%, n=17) and lung (9%, n=3). Most had cutaneous metastases on the chest (37%, n=13) followed by the pelvis (17%, n=6) and 20% (n=7) had skin lesions on multiple sites. Clinically, 46% of patients (n=16) presented with nodule(s), 26% (n=9) with plaque(s) and 20% (n=7) with heterogeneous morphologies. Cutaneous metastases were suspected in 72% of patients (n=25), attributed to clinical features (46%, n=16) or the presence of active metastatic disease elsewhere (26%, n=9). All lesions appeared dermal in origin. ConclusionsCutaneous metastases are highly variable in presentation and a high index of suspicion is required for prompt diagnosis, especially in patients with a history of cancer, regardless of stage of treatment of the primary tumour.